# D

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902152846
- **Authorized official:** STELLA MUNOZ N.D. (NURSE PRACTITIONER)
- **Authorized official phone:** (630) 279-4861

## Contact information

- **Practice address:** 3825 CAMPTON HILLS DR, ST CHARLES, IL 60175-6062
- **Practice address phone:** (630) 584-0506
- **Mailing address:** 3825 CAMPTON HILLS DR, ST CHARLES, IL 60175-6062
- **Mailing address phone:** (630) 584-0506
- **Mailing address fax:** (630) 584-2669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2400X | Prison Health Clinic/Center | 209.004846 | IL | Yes |

## Other

- **Enumeration date:** 07/30/2012
- **Last updated:** 07/30/2012